Organization
REDDING PATHOLOGISTS
Active
Other names
Shasta Pathology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIKOES A. BLANKENBERG M.D. (PARTNER)
(530) 255-1000
Entity
Organization
Contact information
Practice address
2036 RAILROAD AVE, REDDING, CA 96001-1801
(530) 255-1000
(530) 247-8259
Mailing address
PO BOX 994047, REDDING, CA 96099-4047
(530) 255-1000
(530) 247-8259
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
CLF00011395
CA
291U00000X
Clinical Medical Laboratory
CLF11395
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ58543Z
—
CA
Enumeration date
06/28/2005
Last updated
01/16/2013
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